Karen R. Koenig Reaches Those with Eating Disorders

Interview with Karen R. Koenig, Eating Disorder Expert, Coach, and Celebrated Author.


With a desire to help others, Karen Koenig combined her degree in social work with personal experience in the area of eating disorders to become a renowned eating coach and author on the topic. Koenig strives to meet clients “where they are” to help them determine future life goals, enjoying that each client’s case represents a new set of challenges. In addition to working on body image issues, Koenig works through concerns such as depression, dysfunctional relationships, trauma, abuse and more–all potential root causes of overeating.

Koenig began her educational route by receiving a Bachelor of Arts in Elementary Education from Boston University. She then continued on at Antioch College where she received a Masters of Arts in Counseling. Upon graduation, she joined a small start-up that worked directly with clients who overate. This gratifying experience led her to return to school for a Master’s degree in Social Work, which she completed at Simmons College.

Today, Koenig is considered an expert in her field, having authored six books and been featured in dozens of newspaper and  magazine articles, radio shows, and podcasts. She has spoken at a wide range of conferences, hospitals, and adult education centers on the subjects of weight, eating, and body image. In addition, she has conducted professional trainings for the Multi-service Eating Disorder Associations, the Massachusetts School of Professional Psychology, the Massachusetts Dietetic Association and multiple other institutions. She has won several awards her for eating disorder blog.

Enjoy our full interview with Karen Koenig as she discusses the rewards and challenges she experiences while working with clients who are dealing with life-altering eating disorders.

Exploring Social Work Careers: Interview with Eating Coach Karen Koenig

GradSchools: Tell us about your background and education. How did you get initially become involved in clinical social work, and how did that evolve into a career as a psychotherapist?

I had a B.A. in Elementary Education and an M.Ed. before I returned to school to get my MSW. I’d worked as a teacher and in secretarial, advertising, and low-level administrative jobs, then joined a small start-up that offered workshops for people who overate to teach them how to eat “normally.” I worked for them in marketing and facilitating workshops (I had resolved my own overeating problems through a similar approach to the one I was teaching).

I had so many people asking to see me privately for help after class that I decided to return to social work school to become a psychotherapist. I chose Simmons College because of its fine reputation and proximity to where I lived in Boston. After graduating, I worked in a methadone clinic for 6 years, starting as a clinician, then continuing with that job and also becoming a clinical supervisor.

Because of a desire to have more time for my passion of writing, I left the clinic to start my own practice, taking general clients and specializing in addiction and eating disorders. When my husband and I moved to Sarasota ten years ago, I opened my own practice where the majority of my clients are troubled eaters.

GradSchools: You currently work as an eating coach out of your private practice in Florida and also via phone consultations (a.k.a. “tele-therapy”). How and why did you become involved in this niche specialty of social work/psychotherapy?

After resolving my own eating problems, I wanted to help others do so based on an intuitive eating, non-diet, non-weight-loss focused approach. As each of my six books got published, I began to be contacted from people all over the country and the world (three of my books have foreign translations) for help. I considered myself an eating coach, but as more and more began to be written about the viability of tele-therapy for social workers regarding limited licensure, I reconsidered and consulted a mental health lawyer.  Now, the only state I practice tele-therapy/coaching in is Florida.

GradSchools: Define what it means to be an “eating coach” and how these specialized social workers/therapists help people cope with disordered eating. 

Being an eating coach means working with a client’s goals for health and fitness and helping them get there. There is a fine line between coaching and therapy and many of my tele-clients were already seeing general therapists when I started to work with them. Whether coaching or providing therapy, the work is the same in my office or via phone or VSee (like Skype): take the client where they are and help them get to where they want to be. In my practice, I focus on changing beliefs and behaviors, managing emotions effectively, building life skills, practicing good self-care, healing trauma, improving dysfunctional relationships, and resolving mixed feelings about eating better and becoming fit. And I work on body image issues as well.

GradSchools: What are some of the biggest challenges you face as an eating coach, and how do you combat them?

Many troubled eaters think their problems are just about food (this idea is fostered by the diet industry and general superficiality of our culture) and get upset when they realize that dysfunctional eating is rooted in trauma, depression, anxiety, poor life skills, abuse, etc. Another problem is that clients are so impatient to become “normal” eaters that they find slow progress difficult. Then I need to help them be both hopeful and realistic. The biggest problem I have, by far, is that clients are more focused on weight-loss than on becoming tuned in to appetite, reducing stress, finding effective stress relievers, and building healthy life skills.

GradSchools: You’ve written several books about bingeing, overeating, and other types of eating disorders. How much of your writing is informed by your education and training vs. your clinical experience dealing one-on-one with clients? 

I’d say that I’ve learned in three ways that have contributed to each of my books. The first is through resolution of my eating problems (long-term binge-eating and brief bulimia) half a lifetime ago. The second is through my excellent clinical training at Simmons and two great internships there. The third is what I learn from clients. They are my best teachers of what works and what doesn’t and what I do well as their therapist or coach and what I don’t. It’s through seeing what they’re up against that I’ve come up with book ideas. I figure, if something is a barrier for them, it’s a barrier for other troubled eaters as well.

GradSchools: You mentioned that earlier in your career, you felt pressure to “fix” clients or work harder than they’re willing to work on themselves to feel better. Can you elaborate on this?  How did you manage to work through this challenge and place less pressure on yourself? 

I’m lucky that it was drummed into my head in both my MSW internships to never work harder than my clients. First off, that’s a great way to end up burnt out fast and, second, that’s not what coaching or therapy are about. Therapy, especially, is about letting the client set the pace. Sometimes I’m a tad ahead of them, on occasion I lag behind them, but most of the time I try to go along with their pace.

When I feel as if I need to fix a client, I know something’s going on within them—that they’re feeling particularly helpless and hopeless—and that gives me valuable information. And somehow, when I have my moments of trying too hard to fix them, they always let me know my approach isn’t working well. The wonderful thing about how therapy works is that if the therapist stays connected to her feelings, she’s likely learning a great deal about the client and the relationship. This is true in coaching as well.

GradSchools: What your favorite and least favorite parts of your job?

I really adore my work after 30-some years. I’m truly never bored and rarely tired. My favorite time is pretty much any time with clients whether they’re doing well or poorly. In my writing and practice, I use humor a great deal. So if I can make a point with it, that is always a high point. One of my strongest beliefs is that recovery and healing don’t have to be a drag. They can be full of joy and laughter. I think clients take their cue from me that I want to be engaged and having as much fun as possible, depending, of course, on the issues being dealt with.

When I took insurance, that was my most difficult work aspect—all that paperwork. Now my least favorite part is when a client is suicidal. That is terribly scary because I feel so pressured: everything I do and say seems of such enormous potential consequence. Also, I generally feel sad saying goodbye to clients. I love connection and feel the sting when it is broken, even when the client is doing so well that I’m no longer needed. One other thing I loved and miss is a Massachusetts supervision group I participated in and also a monthly private practice group. I haven’t joined a supervision group in Sarasota because there are only a handful of eating disorder specialists, and most of them work with anorexia and bulimia while I work with binge-eating disorder. That said, whenever I run into problems working with clients, I have three therapist friends/colleagues that I can (and do) turn to for help.

GradSchools: What are some of the most valuable skills and traits a successful eating coach can develop? 

It’s important to keep the client focused on goals without making them seem like obligations.  I am not big on clients making commitments, so I need to keep them motivated without that happening. I try to teach them how to view change in such a way that they are self-motivators. I’m a firm believer that we do far better in the long run with internal motivation—from pride in self-care or joy in building life skills—than with external motivation. As the saying goes, I want to teach them how to fish, not simply to fish for them.

GradSchools: Do you have specific advice for students interested in pursuing careers as eating coaches?  What type of coursework do you suggest for students interested in treating patients with eating disorders?

I came into the business through the door of therapy. I knew about eating problems and learned how to coach. I recommend having a background in psychology, but it’s also key to see coaching as separate from therapy. Lifestyle coaching training is big now, so that is one option. But, if a person is going to become an eating coach, she needs to know about eating disorders inside and out. I don’t know if graduate courses teach it now (they didn’t in the 80s when I got my MSW), but there are many books to read and internship possibilities in eating disorders clinics. And they should take as many CEU (continuing education unit) courses on eating disorders as possible. Working with troubled eaters is a specialty. I recommend my book, What Every Therapist Needs to Learn about Eating and Weight Issues, which is helpful for coaches as well to learn about the field, and, Starting Monday—Seven Keys to a Permanent, Positive Relationship with Food, which deals with the underlying, unconscious, internal conflicts dysregulated eaters have which prevent them from attaining and maintaining their health and self-care goals.

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